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Hormone replacement therapy may help prevent heart vessel disease, says Wake Forest researcher

WINSTON-SALEM, N.C. Based on a review of research in postmenopausal women and monkeys, Thomas B. Clarkson, D.V.M., of Wake Forest University Baptist Medical Center, believes that hormone replacement therapy (HRT) has a beneficial role in slowing heart vessel disease after menopause. Clarkson addressed the Third World Congress on Controversies in Obstetrics, Gynecology & Infertility in Washington, D.C. this weekend.

"Mounting evidence points to the conclusion that HRT can help prevent heart vessel disease if the therapy begins around the time that the body stops making its own estrogen," said Clarkson. "The question may not be if estrogen helps, but when is the optimum time to begin therapy."

Clarkson, a professor of comparative medicine, reviewed studies that evaluated the cardiovascular effects of HRT. Included were four large trials of postmenopausal monkeys conducted at Wake Forest over the past 12 years. When estrogen replacement was administered at the onset of estrogen deficiency which compares to the postmenopausal transition in women there was a 70 percent inhibition of fatty build-up in the heart's arteries. In contrast, when estrogen replacement was delayed for a period comparable to six years in women, there was no benefit on the heart's arteries.

In his lecture, Clarkson emphasized the importance of not basing prescribing practices on one or two studies of older women, but rather, evaluating all available data. After reviewing recent clinical trials, Clarkson concludes that mounting evidence supports the probability that estrogen therapies can serve as a primary prevention against cardiovascular disease.

For example, the Estrogen in the Prevention of Atherosclerosis Trial (EPAT), conducted by Dr. Howard Hodis at the University of Southern California, showed that estrogen slows the progression of atherosclerosis, the buildup of fatty deposits in blood vessels that can cause heart disease, in younger postmenopausal w
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Contact: Karen Richardson
krchrdsn@wfubmc.edu
336-716-4453
Wake Forest University
25-Jun-2002


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